Approximately 6.5 million people
in the U.S. have some type of intellectual and developmental disabilities (I/DD), with many requiring specialized care and support, such as home- and community-based services. New federal regulations seeking to streamline reimbursement and improve care have increased the development of a number of new technologies in I/DD, leading to technological innovation within HCBS and the greater industry.
Federal Regulation & EVV
Regulations for home- and community-based services (HCBS) changed significantly with the 21st Century Cures Act, which included a provision for electronic visit verification (EVV) for people with disabilities and caregivers who receive services through Medicaid. EVV was introduced to discourage fraud and improve operational efficiency, with states being required to use EVV for all Medicaid-funded personal care services (PCS) by January 1, 2020, and for all home health care services (HHCS) by January 1, 2023. States failing to comply with the EVV regulation are subject to funding reductions.
While some states have begun to pilot new EVV programs, most states have not yet fully implemented an EVV system, because of certain challenges. States can apply for a one-year exemption and some have done so; however, HCBS providers have already begun to explore EVV systems and additional technologies that can ultimately be leveraged to improve workflow and secure value-based partnerships.
Potentially Useful Technologies
While the introduction of more tech into HCBS may feel like a burden to some, it could also be an unexpected opportunity. For example, partnering with a tech-savvy company that can help track EVV can increase efficiency and help to decentralize care, both of which are common goals among regulators and providers.
Providers looking to integrate EVV-compliant technologies can now find options that not only meet regulatory demands, but also make care more consumer-directed and provide data that helps secure value-based reimbursement (VBR). Examples include:
- Electronic healthcare assessment tools and documentation: Software offered by companies, such as Therap, provides health evaluation tools that are HIPAA-, EHR- and HITECH-compliant. The software not only collects comprehensive data on patients (including visits and care plans), but also provides recommendations for care and case management features.
- Telehealth: This rapidly advancing field is expected to reach a growth rate of 14.9% by 2026, and has expanded access to mental and behavioral healthcare into previously underserved areas using an online platform. Users can track, document, and coordinate care, including applied behavioral analysis (ABA).
- Apps and wearable tech: Many EVV platforms utilize a cellphone or hand-held tablet to track visits, making apps into a major technological innovation and support. In addition, wearable tech can also provide increased personalization by collecting data necessary for EVV compliance.
- EMR software: Providers of electronic medical record (EMR) software, such as CentralReach, not only collect data useful for compliance, but are also using outcome data to help expand options for reimbursable care.
Finding The Funding
The necessary challenge of EVV has not been without a few hiccups, such as the difficulties experienced in Ohio, which include consumer concerns about privacy; access issues for clients and service providers who do not speak English fluently; inconsistent or inadequate training for EVV systems; and device malfunctioning.
These challenges all underscore the need for specific technology funding as states, organizations, providers, and caregivers integrate more tech into their daily routines. One potential source of funding is the Healthcare Extension and Accessibility for Developmentally Disabled and Underserved Population (HEADs UP) Act, introduced with bipartisan sponsorship in Congress. This bill would officially designate individuals with I/DD in the U.S. as a “Medically Underserved Population,” which would open access to over 25 federally-funded programs for those individuals–and provide increased funding for training programs, health centers, loan repayment programs, and research.
Private equity investment offers a potential method of funding, particularly within the ABA marketplace, which has seen a 58% increase in deal volume since 2018. As data collection gets more complex and becomes more tied to compliance and reimbursement, it’s likely investment will be targeted toward building systems that support more robust reporting.
You can learn more about new technologies influencing I/DD, along with other emerging trends, at the upcoming 2020 I/DD Executive Summit. More detailed information and registration for the event are available at https://idd.openminds.com.